What are the special considerations for defibrillator in children less than 8 years of age?

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An AED can be used on children and infants and should be used as early as possible for the best chance of improving the chance of survival. Check the AED when it arrives at the scene. Pediatric pads should be used if the person is less than eight years old or less than 55 pounds (25 kg). Standard (adult) pads may be used if pediatric pads are not available. If using standard (adult) pads, do not let the pads touch. For infants less than a year old, a manual defibrillator should be used if available. If a manual defibrillator is not available, an AED may be used. Some AEDs have a switch that can be set to deliver a pediatric shock. If available, turn the switch on when using on children younger than eight years old. If the AED cannot deliver a pediatric shock, an adult shock should be given. It is important to remember an electric shock may be the treatment for a fatal heart rhythm.

AED Steps for Children and Infants

1. Retrieve the AED (Figure 12a).
   • Open the case.
   • Turn on the AED.
2. Expose the person’s chest (Figure 12b).
   • If wet, dry the chest.
   • Remove any medication patches.

3. Open the Pediatric AED pads (Figure 12c).

• Peel off backing.
• Check for pacemaker or implanted defibrillator.

4. Apply the pads (Figure 12d).

• Apply one pad on the upper right chest above the breast. For infants, apply on the front of the chest.
• Apply the second pad on the lower left chest below the armpit. For infants, apply a second pad to the back (Figure 12e).

5. Ensure wires are attached to the AED box (Figure 12f).

6. Move away from the child (Figure 12g).

• Stop CPR.
• Instruct others not to touch the child.

7. Let AED analyze the rhythm.

8. If the AED message reads “Check Electrodes,” then:

• Ensure electrodes make good contact (Figure 12f).

9. If the AED message reads “Shock,” then:

• Press and hold the flashing shock button until the shock is delivered.

10. Resume CPR for two minutes starting with chest compressions (Figure 12h).

11. Repeat steps 1-10.

Because an AED supplies an electrical shock to the heart, many people are concerned about using a defibrillator on young children and infants. Here’s some guidance from the DefibsPlus Team.

Safety of Using AEDs on Young Children

Firstly, it is important to know that AEDs are safe to use on young children under 8 years old and even infants. Providing effective CPR and using an AED is the best way to treat a child or infant in sudden cardiac arrest (SCA). Without effective CPR and use of an AED to restart the heart, the condition can be fatal within minutes.

Because young children and infants have such small and delicate systems, it is even more critical to get their heart restarted quickly. This will restore the flow of oxygenated blood around their body, supplying the brain and essential organ systems, limiting the damage to these systems.

How to Use an AED on a Child or Infant

• Detect SCA – SCA occurs with little or no warning, and can affect otherwise fit and healthy children. When a child goes into SCA, they will suddenly fall unconscious, stop breathing (sometimes shallow gasping occurs), become unresponsive and have no pulse or heartbeat.
• Contact emergency services They will send an ambulance and stay on the line with you to offer guidance.
• Start CPR – It is very important that you start CPR while retrieving the AED. Effective CPR will supply blood to the brain and other vital organs, prolonging the period that the AED will be effective. If the AED has a paediatric setting, it will tell you how to perform CPR on a young child. For infants, this involves placing two fingers on the centre of the chest and compressing firmly at 100-120 beats per minute. Fully remove your fingers or hand from the chest between each compression to allow the chest to expand. This will circulate the oxygenated blood in their system. You can also supply rescue breaths if you are comfortable doing so.
• Get the AED – Call for an AED. They are often available in schools, day cares, public spaces, gyms, pharmacies and clinics. It is essential to get the AED as soon as possible.
• Turn on the AED – AEDs are designed for anyone to use, so the machine will instruct you on what to do. If the child is wet, dry them and move them away from any water. Some AEDs have paediatric electrode pads (these are the pads you place on the chest) or a switch to change them to a paediatric setting (for children under 8). If your AED does not have a paediatric setting use it anyway.
• Follow instructions – The AED will use voice prompts and/or visual prompts to tell you how to place the electrode pads. If you only have adult pads, you should place one pad in the centre of their chest, and the other one in the centre of their back, aligned with the front pad.
• Follow further instructions – The AED will monitor the child’s heart rhythm and supply a shock as needed (you may have to press a button to trigger the shock), instructing you when to commence CPR and deliver shocks until the emergency services arrive.

Do Not Hesitate to Treat a Child or Infant with SCA

When a SCA occurs, it is up to bystanders to act if their life is to be saved. The first thing you must do is immediately call the emergency services, this will allow them to dispatch first responders and paramedics to your location without delay. In addition the call taker will help you assess the child and if required they will explain how to start CPR.

Starting CPR will ensure that blood is supplied to the brain and other vital organs while an AED is retrieved. Effective CPR prolongs the period that the heart can be restarted by an AED, without CPR the chances of survival drop by 10% every minute.

Early defibrillation increases the chances of survival, when an AED is used by a member of the public before the arrival of paramedics the survival rate is over 60%.

An AED – even if it has no paediatric setting – is the best chance for the patient to survive. The device cannot hurt the child and will not supply a shock unless it is required. Therefore, it cannot accidently shock a child or bystander.

There are few things more tragic than a child passing away suddenly – but the wonderful thing is that there are ways you can help prevent this tragedy by simply acting quickly in an emergency by starting CPR and using an AED. These devices are simple and effective – designed so that anyone can become a hero and save a life.

Get an AED and AED Training

If you would like to purchase an AED for your home, apartment building, school or day care, contact the team at DefibsPlus today. Based in Melbourne, we supply affordable, high-quality defibrillators throughout Australia and also offer bystander training through our HeartSmart program. Together, we can save lives!

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